Global cooperation for pandemic response is collapsing now

After more than two years of discussion and negotiations, the representatives for 194 nations failed to finalize a draft of the Pandemic Agreement, an international accord meant to fix the weaknesses and global inequities in pandemic preparedness that COVID-19 revealed.

The chairs of the World Health Organization's Intergovernmental Negotiation Body (WHO INB), which convened the deliberations, conceded on May 24 that negotiators would be unable to deliver a draft accord in time for the seventy-seventh World Health Assembly (WHA), which begins on May 27 and would have been responsible for approving the treaty.

"Every one of you tried to make this work," Precious Matsoso, INB co-chair, said at the final session. "Everyone was given a huge opportunity to make a difference in people's lives. That's something that none of us can take for granted."

After missing its initial deadline to finalize the pandemic agreement on May 10, the WHO INB carried negotiations into this week in a race against the clock.

Those who followed the process have been largely underwhelmed by the negotiated drafts of the accord relative to its initial ambitions, and the divisive nature of the talks leave questions about what legally binding terms for international cooperation on pandemic preparedness are achievable in the future.

Several domestic political battles had already emerged well before a decision could be made.

In countries including the United States and the United Kingdom (UK), far-right antipathy for international legal agreements and their purported threat to national sovereignty have rendered ratification of the agreement politically divisive. In the United States, all 49 Senate Republicans signed a letter to President Joe Biden demanding that his administration "withdraw support" for the pandemic agreement and IHR amendment at the World Health Assembly given that they "constitute intolerable infringements upon U.S. sovereignty"—"shredding intellectual property rights" and "free speech." They warned that they would consider the two international agreements to be "a treaty requiring the concurrence of two-thirds of the Senate under Article II Section 2 of the Constitution."

Misinformation on social media about the agreement has also bred increasing public resistance against it.

The Accord's Inception

The road formally began in December 2021 when the WHA held its second-ever special session to initiate the process for a "WHO convention, agreement, or other international instrument on pandemic prevention, preparedness and response," establishing the INB as its formal negotiating body. After the catastrophic loss of life and absence of international coordination seen during the COVID-19 pandemic, the agreement's aims, according to WHO Director-General Tedros Adhanom Ghebreyesus, would be to ensure more equitable access to medical countermeasures, safeguard health systems through improved sharing of information about emerging pathogens, and enhance cooperation between member states on confronting health crises.

If ever adopted by the WHA, the pandemic agreement would become only the third legally binding health accord that WHO member states have successfully negotiated, joining the International Health Regulations (IHR), first adopted in 1969, and the Framework Convention on Tobacco Control, adopted in 2005.

The IHR, which defines "countries' rights and obligations in handling public health events and emergencies that have the potential to cross borders," including the mandate to report such events, was largely observed to be both insufficient and ignored during the COVID-19 response. Complementing their call for a new pandemic instrument, WHO member states also launched a parallel negotiating process in 2022 to amend the IHR to strengthen its implementation and compliance. That negotiation has reportedly made more progress but whether the WHA will approve IHR revisions next week or wait to do in tandem with the pandemic accord is still uncertain.

"Let's take the Assembly as an opportunity to reenergize, to be inspired, and to have even more commitment and prepare us to address the problems to get us where we need to be," Adhanom Ghebreyesus told Friday's INB session. "Inshallah, we will conquer this."

Watered Down by Negotiations

Although the WHA's decision to establish the INB was based on broad recognition that countries were not adequately or equitably prepared for COVID-19, two and a half years of unrelenting divisions between member states over the policy's details produced an agreement criticized by many as largely watered down from its initial intent.

Long-standing disputes between high- and middle- to low-income countries over issues of intellectual property protection and resource-sharing persisted throughout the nine INB negotiating sessions and saw little compromise. The sessions were underpinned by a lack of trust on both ends from unsuccessful past international negotiations to the historical trauma of COVID-19 vaccine distribution and legacies of colonialism.